Diabetes and Motor Vehicle Crashes: A Systematic Evidence-Based Review and Meta-Analysis

The primary objective of this systematic review was to address the question, “Are drivers with diabetes mellitus at greater risk for a motor vehicle crash than comparable drivers without the disease?” and secondarily, to address the question, “Are insulin-treated diabetics at higher risk for crash?” Our searches identified 16 articles that addressed these questions. An assessment of study quality of the included studies found them to be in the low-to-moderate range. While attempts were made to control for differences in the characteristics of individuals that may confound the relationship between diabetes and crash risk in all included studies, most failed to control for exposure. A random-effects metaanalysis found that individuals with diabetes have a 19% increased risk for a motor vehicle crash when compared to similar individuals without diabetes. We found no compelling evidence to suggest that insulin-treated individuals are at higher risk for motor vehicle crash than individuals with diabetes not being treated with insulin. We discuss the implications of these findings

Comparison of two multiple-locus variable-number tandem-repeat analysis methods for molecular strain typing of human Brucella melitensis isolates from the Middle East

Brucella species are highly monomorphic, with minimal genetic variation among species, hindering the development of reliable subtyping tools for epidemiologic and phylogenetic analyses. Our objective was to compare two distinct multiple-locus variable-number tandem-repeat analysis (MLVA) subtyping methods on a collection of 101 Brucella melitensis isolates from sporadic human cases of brucellosis in Egypt (n = 83), Qatar (n = 17), and Libya (n = 1). A gel-based MLVA technique, MLVA-15IGM, was compared to an automated capillary electrophoresis-based method, MLVA-15NAU, with each MLVA scheme examining a unique set of variable-number tandem repeats. Both the MLVAIGM and MLVANAU methods were highly discriminatory, resolving 99 and 101 distinct genotypes, respectively, and were able to largely separate genotypes from Egypt and Qatar. The MLVA-15NAU scheme presented higher strain-to-strain diversity in our test population than that observed with the MLVA-15IGM assay. Both schemes were able to genetically correlate some strains originating from the same hospital or region within a country. In addition to comparing the genotyping abilities of these two schemes, we also compared the usability, limitations, and advantages of the two MLVA systems and their applications in the epidemiological genotyping of human B. melitensis strains

Understanding Stakeholder Synergies Through System Dynamics: Integrating Multi-Sectoral Stakeholder Narratives Into Quantitative Environmental Models

To reach the global aspiration of 17 ambitious SDGs, local realities must be integrated. Often, models are developed based on quantitative statistical data sources from databases on environmental indicators or economics to assess how a given SDG can be achieved. This process however removes the local realities from the equation. How can you best include stakeholders in this mathematical modelling processes distanced from their local realities, though, and ensure higher probability of future compliance with top-down global decisions that may have local consequences once implemented? When researching stakeholder involvement and their ability to form public policy, their opinions often get reported as a single assessment, like counting the fish in the ocean once and stating that as a permanent result. Too seldom do stakeholders get invited back and given the opportunity to validate results and allow researchers to adjust their models based on on-the-ground validation or change requests. We tested the full integration of stakeholders in the modelling process of environmental topics in six different case areas across Europe, with each area holding six sectoral and one inter-sectoral workshops. In these workshops, the scope of the issues relevant to the stakeholders was driven by first the sectoral priorities of the given sector, followed by a merging of issues. In this process, we were able to identify what the commonalities between different sectors were and where synergies lay in terms of governance paths. These results were then returned to the stakeholders in a mixed session where they were able to come with feedback and advice on the results researchers presented, so that the models reflected more closely the perceptions of the regional actors. We present these methods and reflect on the challenges and opportunities of using this deep-integration method to integrate qualitative data from stakeholder inclusion in a quantitative modelThe authors would like to acknowledge funding from the European Union's Horizon 2020 Research and Innovation programme under Grant Agreement N° 773782Peer reviewe

Understanding Stakeholder Synergies Through System Dynamics: Integrating Multi-Sectoral Stakeholder Narratives Into Quantitative Environmental Models

To reach the global aspiration of 17 ambitious SDGs, local realities must be integrated. Often, models are developed based on quantitative statistical data sources from databases on environmental indicators or economics to assess how a given SDG can be achieved. This process however removes the local realities from the equation. How can you best include stakeholders in this mathematical modelling processes distanced from their local realities, though, and ensure higher probability of future compliance with top-down global decisions that may have local consequences once implemented? When researching stakeholder involvement and their ability to form public policy, their opinions often get reported as a single assessment, like counting the fish in the ocean once and stating that as a permanent result. Too seldom do stakeholders get invited back and given the opportunity to validate results and allow researchers to adjust their models based on on-the-ground validation or change requests. We tested the full integration of stakeholders in the modelling process of environmental topics in six different case areas across Europe, with each area holding six sectoral and one inter-sectoral workshops. In these workshops, the scope of the issues relevant to the stakeholders was driven by first the sectoral priorities of the given sector, followed by a merging of issues. In this process, we were able to identify what the commonalities between different sectors were and where synergies lay in terms of governance paths. These results were then returned to the stakeholders in a mixed session where they were able to come with feedback and advice on the results researchers presented, so that the models reflected more closely the perceptions of the regional actors. We present these methods and reflect on the challenges and opportunities of using this deep-integration method to integrate qualitative data from stakeholder inclusion in a quantitative modelThe authors would like to acknowledge funding from the European Union's Horizon 2020 Research and Innovation programme under Grant Agreement N° 773782Peer reviewe

Structural Repertoire of HIV-1-Neutralizing Antibodies Targeting the CD4 Supersite in 14 Donors

The site on the HIV-1 gp120 glycoprotein that binds the CD4 receptor is recognized by broadly reactive antibodies, several of which neutralize over 90% of HIV-1 strains. To understand how antibodies achieve such neutralization, we isolated CD4-binding-site (CD4bs) antibodies and analyzed 16 co-crystal structures –8 determined here– of CD4bs antibodies from 14 donors. The 16 antibodies segregated by recognition mode and developmental ontogeny into two types: CDR H3-dominated and VH-gene-restricted. Both could achieve greater than 80% neutralization breadth, and both could develop in the same donor. Although paratope chemistries differed, all 16 gp120-CD4bs antibody complexes showed geometric similarity, with antibody-neutralization breadth correlating with antibody-angle of approach relative to the most effective antibody of each type. The repertoire for effective recognition of the CD4 supersite thus comprises antibodies with distinct paratopes arrayed about two optimal geometric orientations, one achieved by CDR H3 ontogenies and the other achieved by VH-gene-restricted ontogenies

Developmental pathway for potent V1V2-directed HIV-neutralizing antibodies.

CAPRISA, 2014.Antibodies capable of neutralizing HIV-1 often target variable regions 1 and 2 (V1V2) of the HIV-1 envelope, but the mechanism of their elicitation has been unclear. Here we define the developmental pathway by which such antibodies are generated and acquire the requisite molecular characteristics for neutralization. Twelve somatically related neutralizing antibodies (CAP256-VRC26.01-12) were isolated from donor CAP256 (from the Centre for the AIDS Programme of Research in South Africa (CAPRISA)); each antibody contained the protruding tyrosine-sulphated, anionic antigen-binding loop (complementarity-determining region (CDR) H3) characteristic of this category of antibodies. Their unmutated ancestor emerged between weeks 30-38 post-infection with a 35-residue CDR H3, and neutralized the virus that superinfected this individual 15 weeks after initial infection. Improved neutralization breadth and potency occurred by week 59 with modest affinity maturation, and was preceded by extensive diversification of the virus population. HIV-1 V1V2-directed neutralizing antibodies can thus develop relatively rapidly through initial selection of B cells with a long CDR H3, and limited subsequent somatic hypermutation. These data provide important insights relevant to HIV-1 vaccine development

Western scientific approaches to trauma and healing in a non-Western context : a case study of the treatment of trauma in Sudan

In the aftermath of the Cold War, the United Nation Security Council searched for an improved approach to peacekeeping. On this request Boutros Boutros-Ghali, the Secretary- General at that time, put forward the report An Agenda for peace: Preventive diplomacy, peace-making and peacekeeping. This new approach designed by Boutros-Ghali widened the scope of the United Nations involvement from the traditional Peacekeeping operations to Peacebuilding. The general idea was the realization that in order to achieve a positive peace, it would demand more than what traditional peacekeeping had offered. As a result, the United Nations and other actors have become more involved in numerous areas concerning the buildup and reconstruction of post-conflict states. This also includes the psychosocial recovery of individuals and communities (Summerfield, 1999, Wessells, 2007, Zelizer, 2008). However, this increasing trend leads to a dilemma put forward by Professor Harry C. Triandis: “Social psychology is a product of Europe and North America. Almost all that we know systematically about social behaviour was derived by studying individuals and groups from those regions of the world. However, 70 percent of the earth’s population lives outside Europe and North America; in cultures that are quite different from those of the “West” (Triandis 1994). Professor Michael G. Wessells points to the same recognition in his paper Post-Conflict Healing and Reconstruction for Peace: The Power of Social Mobilization where he states: “Increasingly, the international community views healing as a priority in post-conflict situations. Although psychosocial intervention in complex emergencies has become fashionable, this nascent field has a paucity of foundational theory, systematized knowledge about practice, standards for intervention, and widely accepted benchmarks for evaluation” (Wessells, 2007, p. 2).M-I

Selecting Future Leaders - A validation study of the selection process for military leadership education in the Norwegian Armed Forces

The ability to predict future performance is crucial for sustainable selection procedures. While several selection methods individually predict both performance in job training programs and subsequent job performance, of particular interest is the ability of a system of methods to predict performance in related yet different domains. This study investigates the extent to which the selection system for the Norwegian Armed Forces’ Officer Candidate School is able to predict performance during education and training, in addition to subsequent performance in the role as a military leader. Furthermore, the relationship between selection, education and subsequent leadership performance is investigated through assessing the contribution of education and training in predicting leadership performance when controlling for the effect of the selection system. While the selection system is highly predictive of academic performance in the education’s theoretical aspects, it is far less predictive of performance in practical aspects and of subsequent performance in the role as a military leader. Performance during education and training is, expectedly, highly predictive of subsequent leadership performance. Paradoxically, it is performance in the education’s practical aspects that contributes to subsequent leadership performance, while academic performance in the education’s theoretical aspects appears to be negatively (though not significantly) related to subsequent leadership performance. The study concludes that the skills, competencies and abilities required for learning in academic environments are not necessarily important for mastering the practical aspects of military leadership. In such, a tailormade rather than generic competency framework based on identification of specific skills, competencies and abilities directly relevant to a specific job role and its context would facilitate accurate definition of selection criteria, optimization of their use, and ultimately greater accuracy in predicting subsequent on-the-job performance